POS1117 SAFETY AND EFFICACY OF ADIPOSE-DERIVED MESENCHYMAL STEM CELLS FOR OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: M. Gadelkarim, A. Abd Elmegeed, A. Hafez, A. K. Awad, M. Ahmed Shehata, A. Abouelen, A. M. Afifi
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoarthritis (OA) is a debilitating joint disorder affecting articular cartilages and subchondral bones, prompting synovial membrane irritation and inflammation (1). Nowadays, knee OA can be treated either by surgical or non-surgical approaches, while the Osteoarthritis Research Society International (OARSI) suggested pharmacological medications joined with other functional approaches such as exercise, joint inflammation instructions, and weight reduction (2), yet most of them exhibit modest safety and efficacy (3). Mesenchymal stem cells (MSCs) have been well-known in regenerative medicine for their wide differentiation capacity. Moreover, MSCs can be derived from various sources (4); however, Adipose-derived mesenchymal stem cells (ADMSCs) are easiest to assemble for clinical use with higher isolation yields (4). Objectives This study investigated the potential and regenerative capacity of adipose-derived mesenchymal stem cells (ADMSCs) for osteoarthritis (OA). Methods We created a search strategy and applied it to six databases. After screening the records for eligibility, we identified and evaluated the risk of bias in both the randomized and non-randomized research studies. Then, data were extracted and implemented into single-arm and double-arm analyses Results 16 studies with 469 patients were included. We found a significant improvement in the quality of life (QOL) among the three doses subgroups (high, medium, and low doses) which was estimated by the SF-36 scores after a year of follow up (low dose: Mean (M) -23.991; p = 0.000; medium dose: M -15.96; p = 0.000; high dose: M -19.306, p = 0.000). Furthermore, we noticed a significant decrease in pain as estimated by the numeric pain rating scale (NPRS) after three months of follow-up with no significant difference between the low and medium doses (low dose: M -3.119; p = 0.002; medium dose; M -2.17; p = 0.000). Our double-arm analyses illustrated significant pain reduction in the ADMSCs group over the control after 12 months as estimated by WOMAC pain subscore (Mean difference (MD) -1.85, p =0.03); moreover, The knee functions and activity levels improved significantly among the low dose group as measured by the WOMAC physical function and stiffness subscales after six months (M -23.797; p = 0.001; M -10.249; p = 0.009, respectively) and the KOOS scores after 12 months (p ≤ 0.007 for all KOOS subscales). No significant adverse events were observed in the ADMSCs injections group (Event rate (ER) p = 0.001). Conclusion Although ADMSCs were associated with significant reductions in pain scores, improvements in QOL score and knee functions, and achieving disease modification in patients with OA, they did not significantly differ from the control. Therefore, implementing ADMSCs in routine clinical practice needs more studies with large sample sizes, longer follow-up periods. References [1]Morille M, Toupet K, Montero-Menei CN, Jorgensen C, Noël D. PLGA-based microcarriers induce mesenchymal stem cell chondrogenesis and stimulate cartilage repair in osteoarthritis. Biomaterials. 2016 May; 88:60–9 [2]Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil. 2019;27(11):1578–89 [3]Abraham NS, El-Serag HB, Hartman C, Richardson P, Deswal A. Cyclooxygenase-2 selectivity of non-steroidal anti-inflammatory drugs and the risk of myocardial infarction and cerebrovascular accident. Aliment Pharmacol Ther. 2007;25(8):913–24 [4]Lv FJ, Tuan RS, Cheung KMC, Leung VYL. Concise review: The surface markers and identity of human mesenchymal stem cells. Vol. 32, Stem Cells. Wiley-Blackwell; 2014. p. 1408–19. Disclosure of Interests None declared